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The objective of this report is to
present information on the different health financing reform
options available to Kosovo, which can help the government
to make informed... Show More + policy decisions about financing reforms.
The report focuses on the key insurance functions of revenue
collection and management, risk pooling, and purchasing of
health care, as well as the supportive regulatory and
governance framework for health financing. Kosovo aims to
reform health financing by moving toward a health insurance
system. To implement the proposed single insurer as
described in the health law, a draft law for health
insurance was discussed in Parliament in 2004. The draft law
envisioned the revenue sources for the future health
insurance as follows: (i) 60 percent of Health Insurance
Fund (HIF) revenue will be paid by the general budget; (ii)
13.5 percent will come from payroll contributions; (iii) 21
percent will come from direct payments by patients in the
form of user fees; and (iv) 6.5 percent will come from
patients' co-payments. Three years later, in April
2007, the Kosovo Parliament approved a health insurance law
to introduce social health insurance (SHI) financed
predominantly through payroll taxes, though it did not
specify contribution levels. The revenue potential of such
payroll funded insurance was estimated to be modest
considering Kosovo's relatively small formal sector and
employment rate. The Kosovo health system is predominantly
tax funded. Government health spending is about 3 percent of
gross domestic product (GDP) and 10 percent of general
government expenditures. The ministry of economics and
finance (MEF) transfer's health funds from the central
budget to hospitals (51 percent), to municipalities in the
form of an earmarked health grant for the provision of
primary health care (PHC) services (26 percent), and to the
ministry of health (MOH) for other services (22 percent)
(MEF 2007). Show Less -